title: Investment in paediatric tuberculosis prevention in Pakistan: loss or gain?
abstract: OBJECTIVE
  To assess the effectiveness of paediatric tuberculosis prevention, by reevaluation factors in children exposed to tuberculosis from less privileged strata of Pakistan.
  
  
  METHODS
  This cross sectional descriptive study was conducted at National Institute of Child Health, from January 2004 to December 2005. Paediatric patients under 15 years of either gender, diagnosed with active tuberculosis were enrolled. Interviews were conducted with parents regarding common preventive measures and factors advocating tuberculosis spread. Later factors leading to non-compliance to safety recommendations were also evaluated.
  
  
  RESULTS
  Fifty five (70%) children younger than 5 years, had index cases in direct contact within their own house. Fifteen (14%) patients contracted the infection from neighbours, with 11 being older than 5 years. There were 82 (51%) cases with Protein Calorie Malnutrition (PCM). Total of 66(41%) cases of PCM were <5 years age (p < 0.005). Data showed 123(77%) children living in a family with 5 or more members. Sixty eight (55%) children of these large families had to live in a single room house.
  
  
  CONCLUSIONS
  There is a high frequency of direct contact tuberculosis in children belonging to the lower socioeconomic class. This is attributed to poor housing condition and over crowding. The current paediatric tuberculosis prevention strategies as adapted from World Health Organizations' Millennium Development Goals are ineffectual to make changes in children exposed to tuberculosis from less privileged strata of Pakistan. Our societal and demographic factors remain static, continually exposing our children to higher risk of tuberculosis exposure.
authors.affiliation: Department of Emergency Medicine, Aga Khan University Hospital, Karachi.
authors.forename: Emad
authors.initials: E
authors.lastname: uddin Siddiqui
authors.forename: Kiran
authors.initials: K
authors.lastname: Ejaz
authors.forename: Saira
authors.initials: S
authors.lastname: Lone
authors.forename: Syed Jamal
authors.initials: SJ
authors.lastname: Raza
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan; D010349:Patient Compliance; D011502:Protein-Energy Malnutrition / Q000150:complications; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D014944:World Health Organization